Assessment
Resistance Mapping Tool
Document a client's resistance pattern across sessions until its structure becomes readable and the right clinical response becomes clear.
This worksheet helps therapists map the specific forms, contexts, and apparent function of a client’s resistance before selecting a clinical response. Used across three to five sessions, it turns a frustrating pattern into diagnostic information about the problem’s structure.
Complete this worksheet after observing consistent resistance across multiple sessions. Review the completed map before choosing a utilization technique — symptom prescription, pacing, restraint, or avoidance-informed directive design. The map should drive the technique selection, not the other way around.
Resistance Mapping Tool
Client (initials or identifier): _______________ Date of mapping session: _______________ Sessions reviewed: _______________
Specific forms of resistance observed What does the resistance look like — direct refusal, deflection, topic change, apparent compliance followed by non-completion, forgetting, or something else?
What the client resists most consistently What kinds of suggestions, directives, topics, or moments in the session produce the most reliable avoidance?
What the client resists less Where is engagement relatively stronger? What kinds of suggestions, topics, or moments produce less resistance?
Contexts in which resistance intensifies What conditions appear to increase the resistance: specific topics, specific types of suggestions, certain moments in the session, particular relational dynamics?
Contexts in which resistance reduces What conditions appear to allow more engagement or cooperation?
Current hypothesis about what the resistance is protecting What does the avoidance pattern appear to be organized around? What would the client need to engage with if the resistance were removed?
Clinical direction indicated by the map Which approach fits what this resistance pattern reveals? (Circle or note the most applicable.)
- Symptom prescription — indicated when resistance is organized as a relational contest
- Joining — indicated when opposing the resistance has strengthened it
- Pacing before leading — indicated when the therapist has been pulling ahead of the client
- Restraining change — indicated when forward pressure is increasing the resistance
- Avoidance-informed directive design — indicated when previous directives ignored the pattern
- Indirect suggestion — indicated when direct suggestion consistently triggers refusal
Selected approach: _______________________________________________ Rationale: _______________________________________________
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